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Therapy: Thrombolytic Therapy

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Total 73 results found since Jan 2013.

Stroke Care Within the Golden Hour
To the Editor We read with interest the article by Ebinger and colleagues in which they demonstrated that the number of stroke patients treated within the golden hour can be increased up to 6 times compared with a hospital-based approach through a mobile unit staffed with a stroke neurologist and technical personnel as well as a computed tomographic scanner and point-of-care laboratory. In an editorial, Warach questioned the generality of this pack-and-load approach, which was tested in Berlin, Germany, based on financial, logistical, and clinical issues. In the United States, less than one-third of patients receive door-t...
Source: JAMA Neurology - April 1, 2015 Category: Neurology Source Type: research

Computed tomography angiography source images closely reflect the integrity of collateral circulation
Conclusions CTA-SI and CS convey overlapping information. CTA-SI is not a significant predictor of the clinical outcome three months after intravenous thrombolysis when the other CTA-based parameters, CS and the clot location, are considered simultaneously. CTA-SI may have a role in the assessment of the extent of irreversible ischemic changes at admission if contrast injection and image acquisition protocols are designed suitably.
Source: Journal of Neuroradiology - December 13, 2014 Category: Radiology Source Type: research

Prehospital Thrombolysis for Stroke An Idea Whose Golden Hour Has Arrived
Soon after thrombolytic therapy was established as a therapy for ischemic stroke, our colleague Anthony Furlan, MD, famously circulated a cartoon of a computed tomographic (CT) scanner visible through the back doors of an ambulance, where a happy stroke physician had hung a bottle dripping tissue plasminogen activator (tPA) into the scanned patient’s arm. Because the time interval from stroke onset to initiation of thrombolysis after ischemic stroke is inversely related to the probability of disability-free recovery, prehospital initiation of thrombolytic therapy seemed a compelling and logical ambition, if one could rul...
Source: JAMA Neurology - November 17, 2014 Category: Neurology Source Type: research

Le développement actuel de la télémédecine en Allemagne
Conclusion La promulgation récente d’une loi sur l’organisation des soins en Allemagne, incluant la pratique de la télémédecine, et la mise en place d’une stratégie nationale de développement par le ministère fédéral de la Santé sont des signes en faveur d’un développement plus rapide de la télémédecine. Objectives To assess the state of development of telemedicine in Germany in 2013, identify the strengths and weaknesses of existing organisations, as well as the medium-term outlook. Methods Collection of data from the registry established by the institute für Arbeit und Technik and the statistics ...
Source: European Research in Telemedicine - November 1, 2014 Category: Information Technology Source Type: research

World Stroke Organization Global Stroke Services Guidelines and Action Plan
Every two seconds, someone across the globe suffers a symptomatic stroke. ‘Silent’ cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence‐based approaches to stroke prevention, acute stroke management, and stroke recovery. The current challenge lies in implementing these interventions, particularly in regions ...
Source: International Journal of Stroke - September 23, 2014 Category: Neurology Authors: Patrice Lindsay, Karen L. Furie, Stephen M. Davis, Geoffrey A. Donnan, Bo Norrving Tags: Guidelines Source Type: research

HAT Score External Validity: A Predictor Of Hemorrhagic Transformation After Intravenous Thrombolysis (P3.107)
CONCLUSIONSThe consistency of the predictive capability of the scale in two great independent cohorts of t-PA-treated patients ( NINDS and HAT score ), and the presence of similar results in our cohort, indicate that this score is likely to have good external validity.Disclosure: Dr. Neto has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Neto, E. Tags: Cerebrovascular Disease and Interventional Neurology: t-PA Source Type: research

Identifying Barriers in Acute Stroke Therapy in Argentina. ARENAS Registry (P2.014)
CONCLUSIONS: Only 47% of patients were admitted to an Intensive Care Unit, rt-PA was underused and initial evaluation was not performed by a neurologist in most of cases. The gap between clinical practice guidelines and real world is wide in Argentina and interventions to improve acute stroke care are mandatory.Disclosure: Dr. Atallah has nothing to disclose. Dr. Fustinoni has nothing to disclose. Dr. Zurru has nothing to disclose. Dr. Beigelman has nothing to disclose. Dr. Cirio has nothing to disclose. Dr. Ameriso has nothing to disclose. Dr. Burry has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Atallah, A., Fustinoni, O., Zurru, M., Beigelman, R., Cirio, J., Ameriso, S., Burry, G. Tags: Cerebrovascular Disease and Interventional Neurology I Source Type: research

Routine serum C‐reactive protein and stroke outcome after intravenous thrombolysis
ConclusionsAccording to our findings, elevated routine serum CRP measured within 24 h after admission does not seem to independently affect the outcome in patients receiving intravenous thrombolysis for stroke. However, further studies of blood samples taken directly before the treatment are needed.
Source: Acta Neurologica Scandinavica - February 20, 2014 Category: Neurology Authors: M. Karlinski, J. Bembenek, K. Grabska, A. Kobayashi, A. Baranowska, T. Litwin, A. Czlonkowska Tags: Original Article Source Type: research

A multicenter, randomized, double‐blinded, placebo‐controlled phase III study of Clot Lysis Evaluation of Accelerated Resolution of Intraventricular Hemorrhage (CLEAR III)
BackgroundIn adults, intraventricular thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) facilitates resolution of intraventricular haemorrhage (IVH), reduces intracranial pressure, decreases duration of cerebrospinal fluid diversion, and may ameliorate direct neural injury. We hypothesize that patients with small parenchymal haematoma volumes (<30 cc) and relatively large IVH causing acute obstructive hydrocephalus would have improved clinical outcomes when given injections of low‐dose rtPA to accelerate lysis and evacuation of IVH compared with placebo. MethodsThe Clot Lysis Evaluation of Ac...
Source: International Journal of Stroke - August 1, 2013 Category: Neurology Authors: Wendy C. Ziai, Stanley Tuhrim, Karen Lane, Nichol McBee, Kennedy Lees, Jesse Dawson, Kenneth Butcher, Paul Vespa, David W. Wright, Penelope M. Keyl, A. David Mendelow, Carlos Kase, Christine Wijman, Marc Lapointe, Sayona John, Richard Thompson, Carol Thom Tags: Research Source Type: research

Prehospital stroke care: New prospects for treatment and clinical research
Brain cells die rapidly after stroke and any effective treatment must start as early as possible. In clinical routine, the tight time–outcome relationship continues to be the major limitation of therapeutic approaches: thrombolysis rates remain low across many countries, with most patients being treated at the late end of the therapeutic window. In addition, there is no neuroprotective therapy available, but some maintain that this concept may be valid if administered very early after stroke. Recent innovations have opened new perspectives for stroke diagnosis and treatment before the patient arrives at the hospital....
Source: Neurology - July 29, 2013 Category: Neurology Authors: Audebert, H. J., Saver, J. L., Starkman, S., Lees, K. R., Endres, M. Tags: All Clinical trials, All Cerebrovascular disease/Stroke VIEWS & amp;amp; REVIEWS Source Type: research

Intravenous thrombolysis in ischemic stroke with unknown onset using CT perfusion
ConclusionDelayed stroke patients with unknown onset time were no different than patients >4.5 h regarding eligibility and response to CTP‐based i.v. thrombolysis.
Source: Acta Neurologica Scandinavica - July 15, 2013 Category: Neurology Authors: E. Cortijo, P. García‐Bermejo, A. I. Calleja, S. Pérez‐Fernández, R. Gómez, J. M. del Monte, J. Reyes, J. F. Arenillas Tags: Original Article Source Type: research

Thrombolysis Despite Recent Stroke: A Case Series Brief Reports
Conclusions— In our center, we thrombolysed 6 patients despite recent stroke. Three patients had asymptomatic petechial hemorrhagic transformation within the area of subacute infarct, without apparent neurological worsening. Prospective studies are needed to explore the possible safety of tissue-type plasminogen activator in the context of previous subacute stroke in otherwise eligible patients.
Source: Stroke - May 24, 2013 Category: Neurology Authors: Alhazzaa, M., Sharma, M., Blacquiere, D., Stotts, G., Hogan, M., Dowlatshahi, D. Tags: Acute Cerebral Infarction, Thrombolysis Brief Reports Source Type: research

Thrombolytic therapy in total mismatch with severe stroke after acute MCA-occlusion and negative DWI
Total mismatch is a recently described magnetic resonance imaging (MRI) pattern in acute stroke patients with no signal changes in diffusion weighted images (DWI) and extensive hypoperfusion on perfusion weighted images (PWI). The prognostic value and importance for treatment decision based on this finding in MRI have recently been controversially discussed in patients with minor stroke . Here we report a case of a 98-year-old woman that presented with severe stroke and total mismatch in the left middle cerebral artery (MCA) territory in MRI scan and an occlusion of the proximal MCA (M1) in time-of flight MR angiography (T...
Source: Clinical Neurology and Neurosurgery - August 6, 2012 Category: Neurosurgery Authors: Lars Neeb, Frederik Geisler, Matthias Wendt, Andrea Rocco, Jochen B. Fiebach, Kersten Villringer Tags: Case reports Source Type: research